29 October 2013

This story was in the news yesterday about how a "complaints revolution" is needed in the NHS. But a few years ago I came across a much bigger problem with making complaints about negligent medical care. The problem wasn't with the NHS; the problem was with our stupid legal system. I'd have come across the same problem in trying to get justice if a negligent private doctor had been responsible for my mother's death.

I've never written online before about what actually happened to my mum. I've mentioned that she had died without going into the details of what happened. I've told friends off-the-record in real life, but I've never published it on the internet before because that publication could have affected any legal proceedings. But now justice is well and truly off the table, it's something I can write about.

How she died

The story of how my mum died actually begins 10 years and one month before her death. My mum's youngest sister was married to a bloke from mainland Europe and in November 1998 my aunt and her husband flew home from visiting his family. As soon as they landed in this country my aunt started complaining of chest pain. My aunt was overweight, a lifelong smoker and had just flown. Despite these risk factors, when she saw her GP the next day; he diagnosed her with indigestion and gave her Gaviscon.

Five days later she was feeling really ill so went to get an early night. Her husband made her a cup of cocoa and took it up to her. By the time the cocoa was made and he'd carried it up the stairs; she was dead. My 85-year-old nan (who my aunt and uncle lived with) ran barefoot across the street to fetch a neighbour nurse. Said neighbour performed CPR on my aunt until the emergency services showed up, but she was gone. Unsurprisingly she'd had a massive, and instantly fatal, heart attack.

If my aunt's GP had sent her straight to A&E when she presented with chest pains 5 days earlier, it's possible she'd still be alive 15 years later. Of course she just as easily might not be; but it's possible that she would.

The reason the story of my mum's sister's death is relevant is because 10 years later, my mum died the same way thanks to the same response from a GP. Not the same GP, it's important to note: It seems the response is a standard one wherever you see a doctor.

My mum died in December 2008. Her chest pains began around two years earlier, so that would've been 2006. Just as her sister did 8 years before, my mum went to see her GP about her chest pain and was diagnosed with indigestion. Unlike her sister, my mum was prescribed omeprazole - rather than Gaviscon - for the indigestion.

My aunt died within 5 days of the indigestion diagnosis. My mum lasted for 2 years and repeatedly visited her GP during that time. She struggled to push her wheelchair, became unable to lay down flat, and clutched her chest at the slightest movement. You have to remember that this was a woman with osteogenesis imperfecta; she had a fucking high pain tolerance. When she was in hospital as a child with broken limbs, she would still be changing nappies of babies on the children's ward and showing some love that cold-hearted nurses wouldn't. (Parents weren't allowed to visit: Hospital rules.) My mum was not someone who was easily stopped by pain, so for her to stop and clutch her chest while transferring from wheelchair to armchair; she must have been in agony.

For two years she kept going back to her GP, and her GP did nothing. No referral to a cardiologist, no cardiac tests, nothing.

On the 4th of December 2008, she went to go to bed; but couldn't get out of her armchair and into her wheelchair. She couldn't breathe. She admitted defeat and called 999. Once in hospital she was assigned a consultant cardiologist who told her, in no uncertain terms, that "you should have been referred to me two years ago."

Apparently, according to her test results, her heart attack had been massive and she was lucky to be alive. It didn't last. On December 13th at around 10pm her heart gave up and stopped completely.

A few months after mum died, the British Heart Foundation ran an ad campaign on buses with wording to the effect of "chest pain is your body's way of telling you to call 999." Such a shame they don't teach that in medical school. My mum and her sister might still be around if GPs were smart enough to know that chest pains indicate a need to rule out heart problems. Yes, you can say that my mum and her sister should've skipped the GP middle-man and gone straight to A&E themselves. But these were women with no academic qualifications who placed their faith in their GPs, expecting them to be educated enough to treat them.

The legal snag

While mum was in hospital we had a conversation about the need for mum to sue her GP to make sure he didn't treat anyone else so badly. I remember pointing out that she was lucky to be alive and that he could have killed her. Turns out he did kill her: By the time she was hospitalised, she was beyond saving.

Shortly after her death I contacted a lawyer. Obviously I wanted justice for my mum; but what I wanted most was to protect her GP's other patients; to make sure he couldn't kill anyone else with his indifference.

I was told that I couldn't sue because I'm not legally considered my mother's closest living relative: My father is. I once lived inside my mum for 9 months. That's really fucking close. But no; the only person who could sue my mum's GP was my dad.

My dad will not do anything that involves moving from in front of the TV. Anything. For three years I kept begging him to be reasonable, to think about protecting other patients. To try to make him see that if that GP kills anyone else; their blood is on his hands because he could have stopped it.

He wouldn't. He cares more about the patients on Doctors than the patients registered at my mother's doctor's surgery.

You can only instigate a case within 3 years, less one day, of realising the doctor was wrong. So the deadline for initiating legal action was Dec 3rd 2011. That's long gone, so like I said at the start: Any potential justice for my mum is long off the table.

How fucked up does a legal system have to be when a dead woman's daughter is considered too distant a relative to be able to sue the doctor whose negligence resulted in the woman's death? Yes, the NHS complaints procedure needs work and the news yesterday was full of examples as to why. It can be scary complaining, especially if you're complaining about doctors whom your life depends on. But beneath the NHS complaints framework we need a legal system that protects NHS and private patients alike. Sometimes issues are so severe (like fatal negligence) that a surgery complaint form isn't enough and you need to take legal action. We need to fix NHS complaint systems, but we need to fix our ludicrous legal system too.